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Psoriasis, a prevalent inherited skin condition, involves an inflammatory response as a key pathogenic mechanism. The Optimized Yinxieling Formula (OYF), rooted in traditional Chinese medicine, is extensively utilized in clinical settings to treat psoriasis. Although previous studies have demonstrated OYF's significant anti-inflammatory effects in psoriasis, its potential molecular targets and active components remain unexplored. This study aimed to unveil the anti-psoriasis molecular targets and active components of OYF. Our findings indicated that OYF extract markedly reduced the production of several inflammatory mediators, including IL-23, nitric oxide, TNF-α, and IL-1β, in LPS-induced RAW264.7 cells. We synthesized OYF extract-crosslinked beads to isolate pharmacological targets from RAW264.7 lysates using an affinity purification strategy, known as Target Fishing. The enriched target proteins were subsequently identified via LC-MS/MS, followed by bioinformatics analysis to map the psoriasis-associated pathway-gene network. We identified a total of 76 potential target proteins, which were highly associated with mRNA transcription mechanisms. In particular, pathway-gene network analysis revealed that the IL-23 inflammatory pathway was involved in the anti-psoriasis effect of OYF extract. We further utilized a target protein-based affinity capture strategy, combined with LC-MS and SPR analysis, to globally screen OYF's active components, focusing on the mRNA transcription regulator, fused in sarcoma (FUS). This process led to the identification of umbelliferone, vanillic acid, protocatechuic acid, gentisic acid, and echinacoside as key compounds targeting FUS to inhibit IL-23 expression. Additionally, we formulated a compound cocktail (CpdC), which significantly reduced psoriasis area and severity index (PASI) scores and the expressions of IL-23 and Ki67 in an imiquimod (IMQ)-induced psoriasis mouse model. Collectively, our study elucidates the primary molecular targets and active components of OYF, offering novel insights for psoriasis treatment. [ABSTRACT FROM AUTHOR]

Psoriasis is an immune-mediated chronic inflammatory skin disease. Current research suggests that the long-term persistence and recurrence of psoriasis are closely related to the feedback loop formed between keratinocytes and immune cells, especially in Th 17 or DC cells expressing CCR6. CCL20 is the ligand of CCR6. Therefore, drugs that block the expression of CCL20 or CCR6 may have a certain therapeutic effect on psoriasis. Glycyrrhetinic acid (GA) is the main active ingredient of the plant drug licorice and is often used to treat autoimmune diseases, including psoriasis. However, its mechanism of action is still unclear. Psoriasis like skin lesion model was established by continuously applying imiquimod on the back skin of normal mice and CCR6-/- mice for 7 days. The therapeutic and preventive effects of glycyrrhetinic acid (GA) on the model were observed and compared. The severity of skin injury is estimated through clinical PASI scores and histopathological examination. qRT-PCR and multiple cytoline assay were explored to detect the expression levels of cytokines in animal dorsal skin lesions and keratinocyte line HaCaT cells, respectively. The dermis and epidermis of the mouse back were separated for the detection of CCL20 expression. Transcription factor assay was applied to screen, and luciferase activity assay to validate transcription factors regulated by GA. Technology of surface plasmon laser resonance with LC-MS (SPR-MS), molecular docking, and enzyme activity assay were used to identified the target proteins for GA. Finally, we synthesized different derivatives of 18beta-GA and compared their effects, as well as glycyrrhetinic acid (GL), on the skin lesion of imiquimod-induced mice to evaluate the active groups of 18beta-GA. 18β-glycyrrhetinic acid (GA) improved IMQ-induced psoriatic lesions, and could specifically reduce the chemokine CCL20 level of the epidermis in lesion area, especially in therapeutic administration manner. The process was mainly regulated by transcription factor ATF2 in the keratinocytes. In addition, GUSB was identified as the primary target of 18βGA. Our findings indicated that the subject on molecular target research of glycyrrhizin should be glycyrrhetinic acid (GA) instead of glycyrrhizic acid (GL), because GL showed little activity in vitro or in vivo. Apart from that, α, β, -unsaturated carbonyl in C11/12 positions was crucial or unchangeable to its activity of 18βGA, while proper modification of C3 or C30 position of 18βGA may vastly increase its activity. Our research indicates that 18βGA exerted its anti-psoriasis effect mainly by suppressing ATF2 and downstream molecule CCL20 predominately through α, β, -unsaturated carbonyl at C11/12 position binding to GUSB in the keratinocytes, and then broke the feedback loop between keratinocytes and CCR6-expressing immune cells. GA has more advantages than GL in the external treatment of psoriasis. A highlight of this study is to investigate the influence of special active groups on the pharmacological action of a natural product, inspired by the molecular docking result. [ABSTRACT FROM AUTHOR]

Chinese herbal medicine (CHM) bath is commonly used in China as an adjuvant therapy for managing psoriasis vulgaris. Previous systematic reviews showed that CHM bath therapy was effective and safe for psoriasis vulgaris, however, without exploration of the specifics of CHM bath therapy such as the optimal temperature, duration of each session, and the total treatment duration. To evaluate the add-on effects of CHM bath therapy to conventional therapies for adult psoriasis vulgaris. We conducted a comprehensive search in nine medical databases from inception to September 2022 to identify relevant randomised controlled trials (RCTs) published in Chinese or English. The included studies compared the combination of CHM bath therapy and conventional therapies to conventional therapies alone for adult psoriasis vulgaris. Methodological quality assessment of the included RCTs was performed using the Cochrane risk-of-bias tool 2 (RoB 2). Statistical analysis was carried out using RevMan 5.4, R 4.2.3 and Stata 12.0 software. The certainty of evidence of outcome measures was evaluated using the Grading of Recommendations Assessment, Development, and Evaluation Working Group (GRADE) system. A total of 23 RCTs involving 2,183 participants were included in this systematic review. Findings suggested that the combination of CHM bath therapy and conventional therapies was more effective in reducing Psoriasis Area and Severity Index (PASI), Dermatology Life Quality Index (DLQI) and itch visual analogue scale, compared to using conventional therapies alone. These enhanced effects were notably observed when the CHM bath was set above 38 °C and had a duration of 20 and 30 min, as assessed by DLQI. Moreover, an eight-week treatment duration resulted in better effects for PASI compared to shorter durations. Additionally, the top ten frequently used herbs in the included studies were identified. Despite the findings, the certainty of evidence was rated as 'low' or 'moderate' based on the GRADE assessment, and significant heterogeneity was detected in subgroup and sensitivity analyses. The CHM bath therapy combined with conventional therapies is more effective and safer than conventional therapies alone for adult psoriasis vulgaris. The results suggest a potential correlation between treatment effects and factors such as extended treatment duration, increased bath temperature, and longer bath sessions. However, the certainty of evidence was downgraded due to methodological limitations of the included studies. To confirm the findings of this systematic review, a double-blinded, placebo-controlled RCT is needed in the future. [Display omitted] [ABSTRACT FROM AUTHOR]

Psoriasis is an immune-mediated chronic inflammatory skin disease characterized by well-defined erythema and white scales, which affects approximately 2% of the worldwide population and causes long-term distress to patients. Therefore, development of safe and effective therapeutic drugs is imminent. Autophagy, an evolutionarily conserved catabolic process, degrades intracellular constituents to maintain cellular energy homeostasis. Numerous studies have revealed that autophagy is closely related to immune function, such as removal of intracellular bacteria, inflammatory cytokine secretion, antigen presentation, and lymphocyte development. Phytochemicals derived from natural plants are often used to treat psoriasis due to their unique therapeutic properties and favorable safety. So far, a mass of phytochemicals have been proven to be able to activate autophagy and thus alleviate psoriasis. This review aimed to provide directions for finding phytochemicals that target autophagy to treat psoriasis. The relevant literatures were collected from classical TCM books and a variety of databases (PubMed, Google Scholar, ScienceDirect, Springer Link, Web of Science and China National Knowledge Infrastructure) till December 2022. Search terms were "Phytochemical", "Psoriasis" and "Autophagy". The retrieved data followed PRISMA criteria (preferred reporting items for systematic review). Phytochemicals treat psoriasis mainly through regulating immune cell function, inhibiting excessive inflammatory response, and reducing oxidative stress. While the role and mechanism of autophagy in the pathogenesis of psoriasis have been confirmed in human trials, most of the evidence for phytochemicals that target autophagy to treat psoriasis comes from animal studies. The research focusing on the role of phytochemical-mediated autophagy in the prevention and treatment of psoriasis is limited, and the definite relationship between phytochemical-regulated autophagy and treatment of psoriasis still deserves further experimental confirmation. Phytochemicals with autophagic activities will provide new insights into the therapeutic intervention for psoriasis. [Display omitted] [ABSTRACT FROM AUTHOR]

This study aimed to examine the effect of acupuncture on symptoms and health-related quality of life in patients with endometriosis. Nine biomedical databases were searched to April 2022 to identify randomized controlled trials of acupuncture and/or moxibustion used alone or as adjunct to guideline-recommended pharmacotherapy for the treatment of endometriosis. One reviewer extracted data and another verified the data. A random effects model was used to calculate mean differences. Fifteen trials involving 1018 patients met the inclusion criteria, but diversity in comparisons and outcome measures prevented meta-analysis. Compared to sham acupuncture, manual acupuncture was more effective at reducing dysmenorrhea VAS pain score (mean difference [MD] − 2.40, 95 % CI [− 2.80, − 2.00]; moderate certainty evidence), pelvic pain VAS score (MD − 2.65, 95 % CI [− 3.40, − 1.90]; high certainty evidence) and dyspareunia VAS scores (MD − 2.88, [− 3.83, − 1.93]), lessened the size of ovarian cyst (MD − 3.88, 95 % CI [− 7.06, − 0.70]), and improved quality of life. Compared to conventional therapy, manual acupuncture plus conventional therapy and warm needle alone resulted in greater improvements in quality of life than conventional therapy. Among the six studies that reported safety, fewer adverse events were reported in participants who received acupuncture or moxibustion. Low to moderate certainty evidence from single studies showed that manual acupuncture may improve pain-related symptoms and quality of life; however, there is insufficient evidence on the overall effectiveness of acupuncture and moxibustion for endometriosis. • Endometriosis is a very prevalent and costly disability in women. • Current mainstream treatments are associated with many unwanted adverse effects. • Few studies have assessed the effectiveness and safety of acupuncture and moxibustion for symptoms other than pain. • This review found that acupuncture and moxibustion may improve pain-related symptoms and quality of life. • Acupuncture and moxibustion may complement or be an alternative treatment choice for women with endometriosis. [ABSTRACT FROM AUTHOR]

Abstract Background and purpose Chinese medicine is increasingly used by women with postpartum depression (PPD). We systematically analyzed randomized controlled trials of acupuncture and Chinese herbal medicine (CHM) for PPD. Methods Studies were retrieved from English and Chinese databases. The Cochrane risk of bias tool was used to assess methodological quality. Results Fifteen CHM, and three acupuncture studies were included. Low quality evidence suggested that CHM alone or combined with antidepressants as add-on therapy may reduce symptoms of depression compared to placebo or antidepressants on the Edinburgh Postnatal Depression Scale (EPDS). There was no statistically significant difference between acupuncture and antidepressants. Adverse events were rare. Conclusions CHM reduced PPD symptoms greater than placebo or antidepressants. Acupuncture was neither superior nor inferior to antidepressants. More rigorously designed studies are required to confirm the effect of CHM and acupuncture for PPD. Highlights • This systematic review provides up-to-date evidence of acupuncture and Chinese herbal medicine for postpartum depression. • We found Chinese herbal medicine improved depression symptoms and severity compared to antidepressants. • Acupuncture was neither superior nor inferior to sham or antidepressants. • Adverse events were similar to sham/placebo and less than antidepressants. • The full extent of the effect remains inconclusive due to poor quality extant randomized controlled trials. [ABSTRACT FROM AUTHOR]

Background: In Chinese medicine, Ziziphus jujuba Mill. var. spinosa (Bunge) Hu ex H. F. Chou is widely used for the treatment of insomnia.Purpose/sections: This paper summarises the chemistry, psychopharmacology, and compares the pharmaceutical effects of the seeds of Ziziphus jujuba plant, Ziziphus spinosa (ZS) seeds, with benzodiazepines. Whole extracts and constituent compounds have been evaluated in preclinical and clinical studies.Conclusions: ZS secondary metabolites modulate GABAergic activity and the serotonergic system. The actual therapeutic agents require further confirmation/identification so that new insomnia phytomedicines can be discovered. [ABSTRACT FROM AUTHOR]

Introduction Post-herpetic neuralgia (PHN) is a common complication of herpes zoster. Pain medications have shown benefit, however many patients do not achieve adequate pain relief. Oral Chinese herbal medicine (CHM) has been used for people with PHN but its benefit is unclear. This review examined the efficacy and safety of oral CHM alone or as add-on therapy for PHN. Methods Nine English and Chinese databases were searched from their inceptions to March 2016. Randomized controlled trials (RCTs) evaluating oral CHM for PHN were included. Methodological quality was assessed using the Cochrane Collaboration’s risk of bias tool. Data were analysed using Review Manager software. Results Twelve RCTs involving 853 participants were included with low to moderate quality based on risk of bias assessment. Oral CHM as an add-on intervention to pharmacotherapy improved visual analogue scale (VAS) pain score (MD −1.88 cm [−3.34 to −0.42], I 2 = 98%), and scores on the Hamilton Rating Scale for Depression (HAM-D) (MD −2.45 points [−3.70 to −1.20], I 2 = 13%) compared with pharmacotherapy alone. Significant changes from baseline were seen for all groups. No severe adverse events were reported. Conclusions These findings suggested that oral CHM in addition to pharmacotherapy may be beneficial for patients with PHN. Oral CHM alone or combined with pharmacotherapy appeared to be safe. More high quality trials with rigorous research methods are needed. [ABSTRACT FROM AUTHOR]

Objective: Acupuncture is widely used in Asia and increasingly in Western countries. We performed a systematic review and meta-analysis to examine the effects of acupuncture for insomnia.Methods: We identified randomized controlled trials from English and Chinese databases. Data were extracted using a predefined form and analysed using RevMan 5.2. We included studies that compared acupuncture to sham/placebo, standard pharmacotherapy or cognitive behavioral therapy. Risk of bias was assessed using the Cochrane risk of bias tool. The primary outcome was sleep quality assessed by the Pittsburgh Sleep Quality Index (PSQI).Results: A total of 30 studies involving 2363 participants were included. Acupuncture point combinations included the use of at least one of the recommended points for insomnia, HT7, GV20, SP6. Pharmacotherapy control was used in 27 studies and sham/placebo in three studies. Cognitive behavioral therapy was not used in any of the studies. Pharmacotherapies in all studies were benzodiazepine receptor agonists, except for one that used an antidepressant. Acupuncture was superior to sham/placebo in terms of PSQI (MD -0.79, 95% CI -1.38, -0.19, I(2)=49%). Acupuncture was also more effective than pharmacotherapy (MD -2.76, 95% CI -3.67, -1.85, I(2)=94%). Most studies were at risk of bias. Some mild adverse events were reported but they were not causally related to the acupuncture treatments.Conclusions: Acupuncture compared to sham/placebo and pharmacotherapy showed statistically significant results. However, the evidence is limited by bias in the included studies and heterogeneity. Well-designed studies are needed to confirm the results identified in this review. [ABSTRACT FROM AUTHOR]

Background: Psoriasis vulgaris is a modern medical term. In the classical Chinese medicine (CM) literature, this disorder could be classified under a diversity of terms. In order to explore how psoriasis vulgaris was conceptualized and managed throughout Chinese medical history, we undertook a systematic longitudinal analysis of descriptions in the classical CM literature of skin disorders consistent with psoriasis vulgaris.Methods: Candidate search terms were identified from 33 contemporary CM books as relevant to psoriasis vulgaris. Thirteen terms were used to search the Zhong Hua Yi Dian--'Encyclopaedia of Traditional Chinese Medicine', 4th edition, a digital collection of over 1000 medical books. Search results were entered in a spreadsheet, citations that were consistent with psoriasis vulgaris were identified based on: (i) a description of the features of psoriasis vulgaris and (ii) judgment by two clinicians regarding relevance to psoriasis vulgaris. Analysis focused on the use of terms by historical period (Chinese dynasty) and whether the terms were specific for psoriasis vulgarisResults: 608 citations dating from 363 to 1947AD were included. The two criteria for determining inclusion of citations were combined to select the pool of citations most relevant to psoriasis vulgaris. Sixty citations from eight search terms were found in this pool. Among the eight terms, Bai Bi, She Shi and Bi Feng consistently identified citations that were likely to be psoriasis. The earliest was from 1368AD (Ming dynasty). The remaining five terms yielded inconsistent results. Citations of disorders consistent with psoriasis vulgaris appear prior to 1368-1644AD (Ming dynasty), but the terms used were not specific for psoriasis.Conclusions: Bai Bi, She Shi and Bi Feng are the terms most consistently used to refer to psoriasis vulgaris. They first appeared in 1368-1644AD (Ming dynasty) and Bai bi remains in use. Regarding the other terms, certain citations may have referred to psoriasis vulgaris, but in other cases these terms could be used for disorders whose descriptions were inconsistent with psoriasis. [ABSTRACT FROM AUTHOR]

Text mining and other literature-based investigations can assist in identifying natural products for experimental and clinical research. This article details a method for systematically analyzing data derived from the classical Chinese medical literature. We present the results of electronic searches of Zhong Hua Yi Dian (“Encyclopaedia of Traditional Chinese Medicine”), a CD of 1000 premodern (before 1950) medical books, for single herbs, and other natural products used for dementia, memory disorders, and memory improvement. This review explores how the terminology for these disorders has changed over time and which herbs have been used more or less frequently, and compares the results from the premodern literature with the herbs indexed for memory disorders in a modern pharmacopoeia. The searches located 731 citations deriving from 127 different books written between ca. 188 ad and ca. 1920. Of the 110 different natural products identified, those most frequently cited for forgetfulness were yuan zhi (Polygala tenuifolia), fu shen (Poria cocos), and chang pu (Acorus spp.), all of which have been cited repeatedly over the past 1800 years and appear among the 31 herbs indexed in a modern pharmacopoeia. By providing a complete, hierarchically organized list of herbs for a specific disorder, this approach can assist researchers in selecting herbs for research. [ABSTRACT FROM AUTHOR]

This study sought to determine the most common oral herbal formula for menopausal symptoms in classical Chinese medicine textbooks and investigate its clinical effectiveness and potential mechanisms of action. The most common formula used for menopause-like symptoms in past eras was identified from the Encyclopedia of Traditional Chinese Medicine. A systematic review of randomized controlled trials (RCTs) was undertaken and findings from relevant experimental studies were summarized. Licorice (Glycyrrhiza spp.) and jujube (Ziziphus jujuba Mill.) formula (LJF) was used in 63 of the 175 citations (36%) in the classical literature. Evidence from four RCTs showed that while LJF may improve sleep symptoms, there is insufficient evidence to provide recommendations for clinical practice. Experimental studies showed sedative, antidepressant-like, estrogenic and antiprogestogenic actions. LJF has a long history of use for menopause-like symptoms, but further research is needed to confirm its clinical effects and guide clinical decision-making. [Display omitted] • Licorice and jujube formula (LJF) was used for menopause-like symptoms in past eras. • LJF may improve sleep symptoms for menopausal women. • LJF exhibits sedative and anti-depressant activity in pre-clinical studies. [ABSTRACT FROM AUTHOR]

Background: Depression is common in women during perimenopause and menopause. Complementary therapies such as acupuncture and Chinese herbal medicine (CHM) are often utilized by these women. However, the efficacy and safety of these treatments have not been systematically evaluated.Methods: We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs). Nine English and Chinese databases were searched and search terms included perimenopause, menopause, depression, Chinese herbal medicine, acupuncture, RCTs, and their synonyms. Methodological quality was assessed using the Cochrane Risk of Bias Tool.Results: A total of 18 RCTs were identified (6 CHM, 11 acupuncture related therapies, 1 combination of CHM and acupuncture). For Hamilton Rating Scale of Depression (HRSD) and Kuppermans Index of Menopause, tuina-massage, combined therapy of CHM plus acupuncture showed significant benefits at end of treatment compared to antidepressants. Either CHM and acupuncture reduced HRSD scores, indicating less severe depression, showing comparable effects to antidepressants.Conclusion: CHM and acupuncture treatment in perimenopause and menopausal women resulted in reduced severity of depression. Results should be interpreted with caution given the small number of studies included in this review and further RCTs are warranted to validate findings from this review. [ABSTRACT FROM AUTHOR]